House Finance Committee adopts substitute for complex-care residential homes bill, removes 15-bed cap

The House Finance Committee on May 8 adopted a committee substitute for House Bill 73, the measure to create a licensure type for "complex care residential homes," and voted the bill out of committee with individual recommendations and attached fiscal notes.

The substitute removes an earlier 15-bed cap and sets a clean effective date of July 1, 2026. Brody Anderson, staff to Co-chair Neil Foster, told the committee the changes are on page 3 of the working draft and that the 15-bed number that had appeared in prior versions was deleted. "You will notice that this version no longer has that bed that 15 bed number there," Anderson said.

The change matters because the bill creates a new license category intended for residential facilities providing continuous, multidisciplinary 24-hour care for people with complex needs. Emily Ricci, Deputy Commissioner with the Department of Health, told the committee that the new licensure type "can exist independent of any certification from the Centers for Medicare and Medicaid Services." Ricci said section 5 of the substitute still allows the department to apply for Medicaid waivers as needed to align payment for services delivered in those homes.

Committee members asked about timing and implementation. Representative Galvin asked whether waivers would be required; Ricci replied that Medicaid payment mechanisms depend on the individual population and services involved and that the department may be able to use existing state-plan services or work through waiver amendments. Representative Galvin asked whether the July 1, 2026 date means the department will have the licensure ready by then; Ricci said it does: the department intends to complete the regulatory work and to coordinate in parallel with Medicaid on payment streams so the licensure type will be ready by that date.

Members also asked about fiscal impacts. Representative Bynum asked whether the substitute changes the fiscal notes; the department replied it would not. After discussion the committee adopted the working draft and then moved the bill out of committee. Representative Schiragi (moved) asked the committee to adopt the committee substitute as the working document and later moved HB 73, work draft 34-GH-1493/n, out of committee with individual recommendations and attached fiscal notes; the committee recorded no objection.

Discussion-only items and directions were distinguished in committee. The committee adopted the substitute and advanced the bill; staff and the Department of Health were directed to continue regulatory work and Medicaid coordination ahead of the July 1, 2026 effective date.

The next steps are standard for a bill leaving committee: preparation of the committee report and any follow-up from department staff to complete rulemaking and payment-alignment work before the licensure date.